Provider Demographics
NPI:1235746587
Name:CHONG, BEUM HYUN (DDS)
Entity Type:Individual
Prefix:
First Name:BEUM HYUN
Middle Name:
Last Name:CHONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:CHONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2400 SIERRA BLVD APT 5
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4801
Mailing Address - Country:US
Mailing Address - Phone:425-635-8313
Mailing Address - Fax:
Practice Address - Street 1:7215 55TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2601
Practice Address - Country:US
Practice Address - Phone:425-635-8313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105618122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist